Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer
Background and Objectives The purpose of this study is to evaluate the relationship between lymph node status (the number of resected lymph nodes; the number of metastatic lymph nodes, LNM, and lymph node ratio, LNR) and biochemical recurrence, disease-free survival (DFS), as well as overall surviva...
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| Format: | Article |
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PeerJ Inc.
2023-03-01
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| Online Access: | https://peerj.com/articles/15025.pdf |
| _version_ | 1797417585579393024 |
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| author | Weijing Hao Jingzhu Zhao Fengli Guo Pengfei Gu Jinming Zhang Dongmei Huang Xianhui Ruan Yu Zeng Xiangqian Zheng Ming Gao |
| author_facet | Weijing Hao Jingzhu Zhao Fengli Guo Pengfei Gu Jinming Zhang Dongmei Huang Xianhui Ruan Yu Zeng Xiangqian Zheng Ming Gao |
| author_sort | Weijing Hao |
| collection | DOAJ |
| description | Background and Objectives The purpose of this study is to evaluate the relationship between lymph node status (the number of resected lymph nodes; the number of metastatic lymph nodes, LNM, and lymph node ratio, LNR) and biochemical recurrence, disease-free survival (DFS), as well as overall survival (OS) in medullary thyroid carcinoma (MTC). Methods This study enrolled MTC patients at Tianjin Medical University Cancer Institute and Hospital between 2011 and 2019. We used Logistic regression analysis, Cox regression models and Kaplan-Meier test to identify risk factors influencing biochemical recurrence, DFS, and OS. Results We identified 160 patients who satisfied the inclusion criteria from 2011 to 2019. We used ROC analysis to define the cut-off value of LNR with 0.24. Multifocality, preoperative calcitonin levels, pathologic N stage, resected lymph nodes, LNM, LNR, and the American Joint Committee on Cancer (AJCC) clinical stage were significant (P < 0.05) prognostic factors influencing biochemical cure. In univariable analyses, gross extrathyroidal extension, preoperative calcitonin levels, pathologic T classification, pathologic N stage, resected lymph nodes, LNM, LNR, AJCC clinical stage, and biochemical cure were significant (P < 0.05) factors of DFS. When the multivariable analysis was performed, LNR was identified as predictor of DFS (HR = 4.818, 95% CI [1.270–18.276]). Univariable Cox regression models reflected that tumor size, pathologic N stage, and LNR were predictor of OS. Furthermore, multivariable analysis manifested that LNR was predictor of OS (HR = 10.061, 95% CI [1.222–82.841]). Conclusions This study illustrated that LNR was independent prognostic factor of DFS and OS in MTC. In addition, LNR influenced biochemical cure. Further investigations are needed to determine the optimal cut-off value for predicting prognosis. |
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| id | doaj.art-7b1c1fda9be644988bba9fc7ee8b0625 |
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| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:21:56Z |
| publishDate | 2023-03-01 |
| publisher | PeerJ Inc. |
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| spelling | doaj.art-7b1c1fda9be644988bba9fc7ee8b06252023-12-03T11:38:19ZengPeerJ Inc.PeerJ2167-83592023-03-0111e1502510.7717/peerj.15025Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancerWeijing Hao0Jingzhu Zhao1Fengli Guo2Pengfei Gu3Jinming Zhang4Dongmei Huang5Xianhui Ruan6Yu Zeng7Xiangqian Zheng8Ming Gao9Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, ChinaBackground and Objectives The purpose of this study is to evaluate the relationship between lymph node status (the number of resected lymph nodes; the number of metastatic lymph nodes, LNM, and lymph node ratio, LNR) and biochemical recurrence, disease-free survival (DFS), as well as overall survival (OS) in medullary thyroid carcinoma (MTC). Methods This study enrolled MTC patients at Tianjin Medical University Cancer Institute and Hospital between 2011 and 2019. We used Logistic regression analysis, Cox regression models and Kaplan-Meier test to identify risk factors influencing biochemical recurrence, DFS, and OS. Results We identified 160 patients who satisfied the inclusion criteria from 2011 to 2019. We used ROC analysis to define the cut-off value of LNR with 0.24. Multifocality, preoperative calcitonin levels, pathologic N stage, resected lymph nodes, LNM, LNR, and the American Joint Committee on Cancer (AJCC) clinical stage were significant (P < 0.05) prognostic factors influencing biochemical cure. In univariable analyses, gross extrathyroidal extension, preoperative calcitonin levels, pathologic T classification, pathologic N stage, resected lymph nodes, LNM, LNR, AJCC clinical stage, and biochemical cure were significant (P < 0.05) factors of DFS. When the multivariable analysis was performed, LNR was identified as predictor of DFS (HR = 4.818, 95% CI [1.270–18.276]). Univariable Cox regression models reflected that tumor size, pathologic N stage, and LNR were predictor of OS. Furthermore, multivariable analysis manifested that LNR was predictor of OS (HR = 10.061, 95% CI [1.222–82.841]). Conclusions This study illustrated that LNR was independent prognostic factor of DFS and OS in MTC. In addition, LNR influenced biochemical cure. Further investigations are needed to determine the optimal cut-off value for predicting prognosis.https://peerj.com/articles/15025.pdfMedullary thyroid cancerLymph node ratioMetastatic lymph nodeResected lymph nodeDisease-free survivalOverall survival |
| spellingShingle | Weijing Hao Jingzhu Zhao Fengli Guo Pengfei Gu Jinming Zhang Dongmei Huang Xianhui Ruan Yu Zeng Xiangqian Zheng Ming Gao Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer PeerJ Medullary thyroid cancer Lymph node ratio Metastatic lymph node Resected lymph node Disease-free survival Overall survival |
| title | Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer |
| title_full | Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer |
| title_fullStr | Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer |
| title_full_unstemmed | Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer |
| title_short | Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer |
| title_sort | value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer |
| topic | Medullary thyroid cancer Lymph node ratio Metastatic lymph node Resected lymph node Disease-free survival Overall survival |
| url | https://peerj.com/articles/15025.pdf |
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